AIBU to not leave the GP without antibiotics

[Turtlegurl888]

I suspect I have bacterial tonsillitis. I've had a raging fever of between 39 and 40 even when maxxing out the daily allowance of paracetamol and ibuprofen. I can hardly open my mouth or turn my head/neck. My glands are like painful golf balls. Yesterday and the day before, my tonsils were covered in white and yellow patches, but that seems to have lessened today. I was awake every hour last night in sheer agony. I don't know how else to describe this pain. It's like being stabbed in the throat and neck. This started on Friday and its been worse every day since. I can't even speak today.

I have had tonsillitis MANY times, I'd venture to say on at least 100 times throughout my childhood, I really suffered. This feels different. The pain is next level. I can't eat or even drink. I am forcing myself to sip water but I'm screaming internally every time I have to swallow.

I know the Dr will say its viral and to wait it out but I can't. I need something. I have my 15 month old all week with no childcare or another adults help and I'm not going to be able to cope like this. Can I be like, I'm not leaving until I have antibiotics? Or at least a swab test for bacterial? I'm usually a massive pushover and willing to accept a doctor knows more than I do but it's so bad I think I need to stand up for myself.

There are anti viral tablets. Perhaps you could ask your GP for this?

Mothers of young children get tired very easily, and if your throat is painful, you cannot even say soothing words to the toddler. Just having a toddler to care for takes almost all your energy, yet alone battling a sore throat as well. Is there no one who you can turn to for help? Just being able to sleep without interruption would help.

Fighting illness is energy draining too, and especially if you cannot take nourishment. Can you take some of those protein shake meals? It may be difficult to swallow, but that will ease with the nourishment. If you cannot replace lost energy, you will continue to feel beaten and bruised.

First try nourishment, then go to the GP again. Many times I have had infections which only cleared up with antibiotics eventually.

Ring 111 and say you have been to pharmacy and been given antibiotics for suspected strep. You need an urgent antibiotic for your little one. They will tell you to go somewhere. Say no I am not well enough. I know what I need please sort it.

A doctor will call back and prescribe over the phone.

Been here with the goddam strep. Waited way too long to get antibiotics. Took 4 courses of antibiotics and I swear I am just a carrier now!!! But LO was fine as I got those over the phone preventatively straight away.

Calm down lol they weren’t talking about stuff out of a hair dye box 😅

As long as it’s “Food Grade Hydrogen Peroxide” it’s perfectly safe to dilute and gargle with.

How are you today @Turtlegurl888

DS(19) contacted the doctor, was seen and told his tonsillitis was viral and should improve within 10 days, after 8 days he was still getting worse so I suggested he went to the walk in centre (it was the weekend). They took one look, told him he had pharyngitis and prescribed antibiotics. They said if it got worse to go to A&E

I had very similar and it was glandular fever

There is the problem that antibiotics have been over-prescribed and have lost their efficacy - so, if your problem is viral, antibiotics will have no effect on this occasion and if you need them in the future, you may find that you need stronger and stronger doses.

I would definitely be asking for a swab so that the problem can be identified and then treated accordingly. If it's tonsillitis (and you suffer from it regularly), you might want to look into the prospect of having them removed. I know that a lot of doctors are reluctant to do this but sometimes it is the only way - I had to have mine removed when I was 18 after several years of getting tonsillitis nearly every month - not much good when you're training for a stage career! However, it was a necessity as they were making me so ill.

I recently had a tonsillitis and I got 5 days worth of antibiotics from the pharmacy as it was a weekend so I couldn't get a GP appointment.

I felt better once finishing the 5 day course however it was definitely not long enough to completely kill off the infection as it returned a few days later so I then had to book a GP appointment and got given 10 days worth. Just bare that in mind if you feel it's starting to return.

Hope you are feeling better today!

OP and everyone - if you have a situation like OP’s call 111. They will text you a link to confirm your location. They will direct you to the closest pharmacy and send them a referral. By the time you get there they should have it and check you. If you need antibiotics- you’ll have them and be back home soon.

And remember probiotics so you don’t have other problems.

if a child is being refused treatment - remember to remind staff that if an infection is left untreated it can quickly turn to sepsis and septic shock is life threatening. I know. I almost died because a GP missed an infection.

You can order antibiotics online for tonsillitis you complete an online consult, send a photo and it was around £20 collect form the local chemist x

I had my tonsils removed almost 9 years ago at age 26. It was a hard & thankful decision as my late Mum nearly talked me out of it, she really didn’t want me to have the surgery as she was so worried due to my age but it was honestly the best decision I ever made. I was constantly ill & on penicillin antibiotics, it was horrendous.

Now for the last 6 or 7 years I’m plagued by bacterial sinus infections which isn’t much better, needing antibiotics almost every time as I just get so ill from it.

No joke, I would opt to have these removed too. 😅 (if only it was possible) lol.

I’ve had this - I used to get tonsillitis a lot and the last few times I went to the GP they refused me antibiotics even with white spots. Then I simply stopped going and just rode it out. They wouldn’t treat my antibiotics and they wouldn’t remove them either. Eventually, I stopped getting it and haven’t had it since. My relative had it so bad he ended up in A&E because his were so enlarged he couldn’t breathe - and they still wouldn’t remove them. Dr’s are really funny about tonsils!

If you’ve been on antibiotics then the swab/throat culture won’t be very effective.
Try to insist on referral for tonsillectomy

Insist on antibiotics. When my daughter was around 17 she went to the G.P with what she knew was tonsillitis (she'd had it loads of times previously) she was refused antibiotics and like you described was in agony all through the night the next day a Saturday she was running a temperature delirious, hallucinating. I rang the out of hours Dr. who got her an emergency appointment at the ENT department at the local hospital. When she was examined by the consultant he went ballistic and admitted her he was so incensed that she hadn't been given antibiotics he wrote to the G.P. She has had the occasional bout since and has never been refused antibiotics. Insist

OP I hope you're still reading replies @Turtlegurl888 I had the exact same as you recently and also got a 5 day course of antibiotics from the chemist. Shortly after the sore throat came back with a vengeance and the GP finally saw me and said in the first place I should have had a 10 day course NOT 5. You MUST get to a walk in/GP etc and get a 5 day course tagged onto your current course before it ends. 5 days is not enough to kill off true bacterial tonsillitis/throat infection.

During Christmas DH called NHS24, when he gave his symptoms to the GP that called him back they faxed an AB prescription to our local pharmacy. Call them when your surgery closes and you might get given an out of hours appointment.

I’ve usually felt a benefit after the first dose of antibiotics. I had cystitis once that felt like I was sitting in a better patch as it was burning consistently (the Dr said it was a really bad case) after the first dose I felt a tiny bit better and after two doses I felt at least 60% better. This is why you are reminded to take the full course as some people start to feel better and stop the medicine too soon.

i done had a bacterial chest infection with a really deep cough, after 1 dose the cough was quite a bit better and within a day it was almost gone (I did finish that course though) so they work really fast.

You've described exactly how I was about 3 weeks ago. My daughter and I were both ill with temperatures, she had it about 2 days before i did. I suddenly couldn't even swallow water without being in severe pain. We both went to out of hours and were told it was viral. The next day I could see white spots on my tonsils so I went back, I was immediately prescribed antibiotics. My daughter still appeared to be 'viral'. The following day she slept for almost the entire 24 hours, she could only wake up for small periods of time. The gp told me to take her to a&e when I called, the doctor at a&e was still convinced it was viral, but if she still had her temperature 48 hours later, to give her antibiotics. She did, so I picked them up and started them. She finally got better after about 48 hours on them. I don't know what kind of ramped up tonsillitis that was, but that was not how I remembered it as a child!

After reading the comments, I feel like this might just be shouting into the void, as the perception that prescribing antibiotics easily is a sign of a good clinician seems too ingrained. In reality, it's quite the opposite. A consult for a sore throat or cough is very very easy and short if you're going to prescribe antibiotics: "Hi Dr, I've got a sore throat, I need antibiotics" – a quick look, check temperature and pulse, ask about allergies, and hand over a prescription. Super easy. But this approach would only he taken by clinicians who are either lazy or indifferent to the potential harm to their patients.

The approach of addressing the patient's belief that they need antibiotics, explaining why antibiotics might not be necessary in a supportive manner, guiding them on self-care for their symptoms, and educating them on when treatment is actually required. Potentially a challenging consult especially if someone's arrived with the mindset of demanding/refusing to leave until a prescription is issued. Taking the time to not prescribe is far more effort, time consuming and costly then issuing a prescription you know isn't needed. There's certainly no monitary benefit in not prescribing - these antibiotics are very cheap, the Dr's clinic time not so. So to believe it indicates lazy/poor practice/uncaring Dr is really not correct.

It's important to understand that while pharyngitis and tonsillitis can be viral or bacterial, neither typically requires antibiotics. Even with bacterial infections, your body can usually clear them just as quickly on its own. At best, antibiotics might reduce symptoms by only 16 hours. This is why antibiotic prescriptions are decreasing and should continue to do so.

For reference, the NICE guidelines, which establish best practices for clinicians in the UK, state the following for acute sore throats (including pharyngitis and tonsillitis):

• Acute sore throat is self-limiting and often triggered by a viral infection of the upper respiratory tract.
• Symptoms can last around 1 week, but most people recover within this time without antibiotics, regardless of whether the cause is bacterial or viral.

Based on these guidelines, the advice for patients for which the assessment toold indicate antibiotics can be given:

• Consider no antibiotic prescription with advice or a back-up antibiotic prescription, taking into account:
• Evidence that antibiotics make little difference in how long symptoms last (on average, they shorten symptoms by about 16 hours).
• Evidence that most people feel better after 1 week, with or without antibiotics.
• The unlikely event of complications if antibiotics are withheld.
• Possible adverse effects, particularly diarrhea and nausea.

Even if you score the maximum points on fever pain or centor (the assessment tools for considering antibiotics), so you've got every single sign pointing towards a 'severe bacterial' tonsillitis it's still advising to only consider antibiotics, i.e. still can be appropriate to not give any antibiotics:

"Consider an immediate antibiotic prescription (see recommendation 1.3.1 for choice of antibiotic), or a back-up antibiotic prescription with advice (see recommendation 1.1.9), taking account of:

• the unlikely event of complications if antibiotics are withheld
• possible adverse effects, particularly diarrhoea and nausea."

The only patient group the guideline state need to be prescribed to are:
"People who are systemically very unwell, have symptoms and signs of a more serious illness or condition, or are at high-risk of complications".

By systemically very unwell this is going to be patients who could be septic/high pulse, low bp, dropped urine output, stopped all typical activities....

https://www.nice.org.uk/guidance/ng84/chapter/recommendations

If your tonsils are the way you describe then it will be obvious to your GP that you have bacterial tonsillitis. They don't mess about with throats, they are kind of essential to life. The blotches on your tonsils, alone, is an indication that your infection is bacterial. You need to get to the Surgery asap, you can't mess around with these infections, it could be something more serious (Quinsy, or Peritonsillar abscess) so you should be seen as a matter of urgency. It's usually pretty obvious to a prescriber when something is viral vs bacterial.
(Retired Nurse Practitioner)

I am not out to encourage anyone to take alcohol for anything, but for decades I have kept a bottle of white port on hand for medicinal purposes. In some respects it is much the same as antibiotics, in that if you take it regularly instead of using it as a medicine, it won't work.

It is the best thing I have ever had for a dry cough, and it works for sore throats too, Just a spoonful. A dry cough will go with the first swallow. It might sting a bit for a sore throat, but it is worth trying. I often have a dry cough at night, so keep a small dose in a glass by the bed just in case. I hardly ever need it. The red port works as well, but it attracts fruit flies into the room unless it is covered.

Mil for mil it is far cheaper than cough syrup and faster working. It is a very old fashioned cough cure, and helped my late husband when mixed with warm water. It is NOT suitable for children, and two spoonful's will not work better. Everyone who I have recommended it to is surprised at how fast it works.

@llizzie

for decades I have kept a bottle of white port on hand for medicinal purposes

'Absolute total peak mumsnet', I am thinking. Also at the same time, 'Hmmm... what's that song my dad used to play? Aha! 'White Port and Lemon Juice' by the Four Deuces, the Bel-Airs and also Frank Zappa and the Mothers of Invention...'

Chorus
White port and lemon juice
White port and lemon juice
White port and lemon juice
Ooh, what it'll do to you

Well, the W is white
The P is the port
L is the lemon
And J is the juice

[chorus]

You take the bottle
You take the can
Shake "em up fine
You got a good good wine

(etc)

Next thought was... where can I get some?

Without frightening you, please don’t leave this, go to accident and emergency if you can’t get the help you need from
your GP. My cousin was 38, and she also had bacterial tonsillitis, she left it too long and even after being prescribed anti biotics, she died of a cardiac arrest whilst waiting for the pharmacist to dispense them. She was the most lovely lady.x she never wanted to see a doctor and said she would be fine. But she left it a little too late as it turned to sepsis. Please ask to be seen again.

5 day penicillin course will tame it for a fortnight and it'll be back. Why they don't do a proper full course is beyond me because you end up going back again and again.

Oh OP you have my sympathies. I used to get tonsillitis on a regular basis. In the end I insisted that they take them out as it was impacting my life (I was at uni training to be a teacher and every placement would see me off sick for a week with tonsillitis). If you get them often, why don’t you ask that they remove them?
Soluble cocodamol is a good painkiller for tonsillitis. If you can’t get in with your GP, perhaps call 111.